D G Bostwick

..Multiple clinical trials to date of men with PIN have had modest success in delaying or preventing subsequent cancer...

..Pathologists must be aware of these distinct changes because of the reliance placed on nuclear and nucleolar size in the identification of prostate cancer, particularly in small specimens and lymph node metastases...

..Uniformity of pathologic reporting should improve the comparability of different studies and therapies and provide more accurate information to urologists in managing patients...

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..Androgen deprivation therapy decreases the prevalence and extent of PIN, suggesting that this form of treatment may play a role in chemoprevention...

..The purpose of this study was to compare the expression of AMP in benign prostatic epithelium, high-grade prostatic intraepithelial neoplasia (PIN), and adenocarcinoma...

..Numerous findings have proven to be of value, including simple quantitation of histopathologic features, cancer volume, perineural invasion, and others...

..Some pathologists may prefer additionally to report synonymous classification in other schemes, but this is discouraged owing to variations and difficulties in translations...

..Androgen deprivation therapy decreases the prevalence and extent of PIN, suggesting that this form of treatment may play a role in chemoprevention...

..Multiple chemoprevention trials are planned or under way to address this hypothesis...

..There is a great need for accurate treatment and outcome prediction in cancer. Two methods for prediction, artificial neural networks and Kaplan--Meier plots, have not, to the authors' knowledge, been compared previously...

..To assess the magnitude and causes of over-diagnosis of prostatic intraepithelial neoplasia (PIN), as large differences are reported in the incidence of high-grade PIN, probably because of the variance in diagnosis and interpretation...

..This report summarizes the existing literature regarding changes in tissue expression of proteins, as determined by immunohistochemistry, and the clinical implications of these changes...

..Phyllodes tumor of the prostate is a rare neoplasm of uncertain malignant potential. We studied a large series of phyllodes tumors to define the combination of histological features that are most useful for predicting patient outcome...

..We hypothesize that carcinogenesis in the prostate results from impaired cellular handling of mutagenic agents owing to reduction or loss of expression of multiple GST and other detoxifying and antimutagenesis agents...

..Prostatic stromal hyperplasia with atypia is a rare lesion that can be mistaken for sarcoma because of the presence of atypical, bizarre, degenerative myocyte nuclei...

..To determine the incidence and long-term follow-up of the 'vanishing cancer' phenomenon, as complete sampling of some radical prostatectomy (RP) specimens reveals no residual cancer...

..Identification of atypical small acinar proliferation warrants repeat biopsy for concurrent or subsequent invasive carcinoma...

..Chemoprevention trials with agents such as finasteride that alter morphology should not rely on cancer grading as a secondary endpoint owing to grading bias...

..An understanding of the risk factors for prostate cancer has practical importance for public health research and policy, genetic and nutritional education and chemoprevention, and prevention strategies...

..In contrast, nodal cancer volume was predictive of distant metastasis-free survival and cancer-specific survival...

..Evidence has accumulated that cancers invading the superficial muscle wall (T2a) behave similarly to those invading the deep muscle wall (T2b). Quantitative analysis of the depth of invasion in relation to patient outcome is needed...

..52 and 0.17, respectively). Our data indicate that assessment of cell proliferation in nodal metastasis is predictive of clinical outcome in prostate cancer patients with regional lymph node metastasis...

..Conversely, Gleason grade in postirradiation needle biopsy specimens appeared to provide useful predictive information and should be reported...

..In the current study the authors attempted to identify such predictors of cancer progression in a large series of untreated patients with lengthy follow-up...

..Recently, p73, a first homologue of p53, was identified and considered to be an imprinted tumor suppressor gene. Thus, we analyzed the possible role of p73 in human prostate cancers...

..Results of published reports on survival among patients with lymph node metastasis are difficult to assess because of treatment selections. The extent to which lymph node status will have an impact on a patient's survival is uncertain...

..Paraganglioma of the urinary bladder is rarely encountered and its biologic behavior is uncertain. The authors sought to determine the prognostic factors that would predict patient outcome...

..06 and 0.01, respectively). These findings indicate that p21 and p27 expression levels are significant predictors of survival for patients selected for salvage prostatectomy for recurrent prostate cancer...

..To the authors' knowledge, there is no previous report of squamous papilloma of the urinary tract. It is uncertain whether there is a correlation between squamous papilloma, condyloma acuminatum, and verrucous carcinoma...

..Nephrogenic metaplasia with cytologic atypia (atypical nephrogenic metaplasia) is occasionally encountered and its biologic potential is uncertain...

..Clinical outcomes vary for patients treated with radical cystectomy. The authors sought to identify factors associated with the survival of patients treated with radical cystectomy for urothelial carcinoma of the urinary bladder...

..We sought to identify factors associated with cancer progression in a series of patients with stage T1 bladder carcinoma treated with a contemporary therapeutic approach...

..Recent international agreement on the pathologic staging of prostate cancer should allow valid comparisons of surgical treatment from different institutions...

..Molecular analysis of microsatellite alterations of biologically distinct tumor cell subpopulations from the same patient may aid in the determination of tumor origin and further our understanding of the genetic basis of cancer progression...

..The authors conclude that urothelial dysplasia is a significant risk for the development of CIS and invasive urothelial carcinoma, and patients with urothelial dysplasia should be followed up closely...

..The coexistence of tumor subclones with morphologic heterogeneity can lead to the formation of a clinically detectable tumor...

..Androgen deprivation therapy and radiation therapy decrease its prevalence and extent, suggesting a role in chemoprevention...

..An international consensus has been reached regarding diagnostic criteria for papilloma of the urinary bladder. However, the incidences of recurrence and progression in patients with urothelial papilloma are uncertain...

..We previously described the diagnostic category called atypical small acinar proliferation (ASAP), suspicious for but not diagnostic of malignancy, present in about 2.5% of routine prostatic needle biopsy specimens...

..This method will provide important data to determine whether a model of spontaneous PIN in elderly dogs may have clinical utility in developing strategies directed toward preventing and treating prostate...

..Urothelial carcinoma of the bladder often contains areas with different histologic grades. The influence of cancer heterogeneity on grading and its relation to patient outcome is uncertain...

..CK5/6 staining of the basal cells in foci of atrophy is sensitive and specific for excluding prostatic adenocarcinoma with and without androgen-deprivation effect...

..This helps to prevent misinterpretation of histologic mimics of cancer, such as atrophic acini and high-grade prostatic intraepithelial neoplasia, that result from false-negative staining...

..Recent international agreement on pathologic staging of prostate cancer should allow valid comparisons of surgical treatment from different institutions. The vanishing cancer phenomenon is also briefly discussed...

..However, primary Gleason grade does not provide any additional information than other known prognostic factors, such as preoperative PSA, seminal vesicle invasion and DNA ploidy...

..We describe the expression of a potentially new tumor marker, human glandular kallikrein 2 (hK2), that may be useful as an adjunct to prostate-specific antigen (PSA) in the diagnosis and monitoring of prostate cancer...

..These results suggest that acid ceramidase may play an important role in prostate carcinogenesis...

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..This article reviews the importance of multifocal prostate cancer and the application of focal treatment...

..Prostate needle biopsy (PNB) ploidy status has proven utility to predict adverse outcomes after prostatectomy. We sought to develop models to predict ploidy status using clinicopathologic variables...

..All cases showed positive CK7 immunoreactivity in the primary cancers and matched lymph node metastases. CONCLUSIONS:-CK20 immunoreactivity is reliably observed in metastases from bladder cancer when the primary tumor expresses CK20...

..The uPM3 is an independent and specific biomarker that detects prostate cancers of similar volume, location, extent and grade as other tests for early detection. uPM3 does not preferentially identify large or aggressive prostate cancers...

..Treatment changes in the benign and cancerous prostate create diagnostic challenges in pathologic interpretation, particularly in needle biopsy specimens and in evaluation of extraprostatic metastases...

..The authors sought to investigate the utility of chromosomal anomalies for the detection of endometrial hyperplasia and carcinoma using multitarget fluorescence in situ hybridization (FISH)...

..Our results indicate that the incidence of corpora amylacea in adenocarcinoma is low, but the presence of such inclusions cannot be used to exclude malignancy...

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..Four local recurrences were seen, with a follow-up for 3 to 16 years (mean, 7.4 years), but no evidence of sarcomatous transformation occurred. Despite worrisome histologic appearance, a benign clinical behavior was seen in all cases...

..We must implement statistical approaches that integrate the new molecular biomarkers with existing prognostic biomarkers to accurately predict which patients require treatment and to determine the optimal therapy...

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..These data suggest that the p73 is unlikely to be a tumor suppressor gene, but that overexpression of p73 may contribute to tumorigenesis in bladder cancer...

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..Immunohistochemical studies with antibodies to PSA and keratin 34BE12 are helpful in separating mesonephric remnants from adenocarcinoma, similar to the case of other benign mimics...

..Gadolinium-enhanced MRI gives the urologist a useful tool to evaluate the effectiveness of new minimally invasive therapies...

..Subtotal gland ablation by minimally invasive therapies such as cryotherapy demands preoperative prediction of unifocal, unilateral, margin-negative, and small volume (less than 0.5 mL) cancer...

..These procedures have applications for BPH and prostate cancer, although some studies are limited to only 1 disease. CONCLUSIONS: Minimally invasive procedures show promise of a durable replacement for surgical resection...

..However, neuroendocrine expression was marginally useful for predicting the outcome in patients with node positive prostate cancer treated with radical prostatectomy...

..The accuracy of prostate cancer detection is influenced by the length and number of biopsy cores...

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..The inverted CD4/CD8 ratio in the intraepithelial compartment suggests that cytotoxic/suppressor T cells are the first line of defense against luminal foreign agents reaching the prostate through retrograde flow...

..Quality-of-life measures did not show any differences between the 2 groups. This study showed no evidence of benefit from flutamide as a chemoprevention agent in men with HGPIN...

..We assessed the performance of the ImmunoCyt immunocytochemical test for detecting bladder cancer recurrence in patients with prior superficial bladder cancers compared with cystoscopic and histological findings...

..The separation of chromophobe renal cell carcinoma, oncocytoma, and clear cell renal cell carcinoma using light microscopy remains problematic in some cases...

..Inhibition of aberrant promoter methylation could theoretically prevent carcinogenesis...

..Fluorescence in situ hybridization (FISH) of voided urine sediment is a sensitive and specific test for the detection of urothelial carcinoma. The time required for slide preparation using the conventional cytospin method is lengthy...

..Most have been included in the 2004 edition of the WHO classification of tumors of the urinary system and male genital organs. Tubulocystic carcinoma needs to be studied and characterized more fully...

..6-fold and represents a quality assurance consideration. The effect of length on cancer or nonbenign detection was maximal at the prostatic apex where the cores were shortest...

..7 (interquartile range = 0.2-2.8) for the control dogs ( P =.04, Mann-Whitney U test). These data suggest that dietary selenium supplementation decreases DNA damage and increases epithelial cell apoptosis within the aging canine prostate...

..Its reproducibility from operator to operator suggests that it may be useful for guiding rebiopsy of specific locations within the prostate and for providing targeted focal prostate cancer therapy...

..In particular, A-80 staining of biopsies may be useful in detecting residual and/or recurrent prostate carcinoma after radiation or hormonal therapy...

..Interobserver variability for EPE and SM interpretation was principally related to the lack of a clearly definable prostatic capsule and crush/thermal artifact along the edge of the gland, respectively...

..5 mg dutasteride daily decreases the risk of biopsy detectable prostate cancer. All men underwent biopsy before study entry, allowing review of the relationship between histological prostate inflammation and prostatitis symptoms...

..We suggest that these data provide insight into the molecular nature of clinically aggressive prostate cancer...

..Anti-EGFR and/or antiandrogen agents may be potentially useful for management of patients with tumors expressing EGFR and/or androgen receptor...

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..In conclusion, karyometry can detect an abnormal chromatin pattern and distribution in the normal-looking urothelium adjacent to papillary carcinoma. Such alterations correspond to the so-called "malignancy-associated change."..

..While both epithelium and stroma are clonal proliferations, they appear to have different clonal origins...

..Differences in nuclear morphometry suggested the additional possibility of gene-nutrient interactions...

..To perform the first evaluation of the effects of the 5-alpha-reductase inhibitor class of drugs on cancer histopathologic features at radical prostatectomy in a placebo-controlled multicenter trial...

..Pleomorphic giant cell carcinoma is a rare variant of prostatic adenocarcinoma with a poor prognosis that should be considered in the differential diagnosis of prostatic pleomorphic tumors...

..105) or carcinoma (p=0.0820). All foci of nodular hyperplasia, AAH, and carcinoma were diploid. Ploidy status and our selected panel of antibodies did not discriminate among these 3 entities reliably...

..We conclude that incidentally detected cancer is less aggressive than clinically detected cancer...

..Prostate safety is a primary concern when aging men receive testosterone replacement therapy (TRT), but little information is available regarding the effects of TRT on prostate tissue in men...

..To review atypical focus suspicious but not diagnostic of malignancy in needle biopsies of the prostate, also referred to as "atypical small acinar proliferation suspicious for but not diagnostic of malignancy."..

..Our objective was to evaluate microvessel density as a molecular marker for distinguishing HGPINs that have the potential of progressing to cancer...

..This form of minimally invasive in situ ablative therapy appears promising. Clinical trials in the kidney and in other abdominal and pelvic organs are pending...